Integrating Addiction Medicine Into Burn Care: Optimizing Pain Management in Stimulant-Positive Patients.

Stimulant use poses significant challenges in burn care, complicating pain management and leading to poorer outcomes, including longer hospital stays, higher complication rates, and increased healthcare costs. This study evaluates burn-related outcomes in stimulant-positive patients, as well as tabulates how frequently addiction medicine consultations are used in burn patients with positive stimulant screens. Patients with positive urine toxicology screens for stimulants, including amphetamines and cocaine, were identified.

Violent burns are associated with poorer life satisfaction and unemployment after injury.

Background: Assaults can result in violent burn injuries, leading to a profound impact on survivors. These burns can cause physical pain, psychological trauma, and challenges in employment. In this study, we aim to explore socioeconomic demographics and longitudinal psychosocial outcomes associated with violent burns.

Ibuprofen is Not Associated With an Elevated Bleeding Risk or Transfusion Requirement in Skin Grafting for Patients With Burn Injuries.

Ibuprofen, a non-steroidal anti-inflammatory drug, can increase the risk of bleeding, a significant concern in burn surgery, which often involves substantial blood loss. This study aims to evaluate the safety of ibuprofen use in burn patients undergoing skin grafting. A retrospective case-control chart review was conducted for patients admitted with acute burn injury from January 1, 2024 to July 31, 2024 who underwent skin grafting.

Factors associated with delayed admission to the burn unit: A major burn center's experience.

Background: Timely admission to the burn unit is crucial. Ideal burn care requires prompt interventions such as wound and body temperature management, infection control, and fluid resuscitation to prevent complications like burn progression and infection. In this study, we identify specific factors and outcomes associated with delayed admission to a regional burn center.

The Emerging Role of GLP-1 Agonists in Burn Care: What Do We Know?

Glucagon-like peptide-1 (GLP-1) agonists mimic the action of GLP-1, a hormone that regulates blood glucose levels via stimulation of insulin release and inhibition of glucagon secretion. After the burn, the current literature suggests that the use of GLP-1 agonists results in less insulin dependence with similar glucose control and hypoglycemic events to patients receiving a basal-bolus insulin regimen. Glucagon-like peptide-1 agonists may also promote wound healing through various mechanisms including angiogenesis and improved keratinocyte migration.

Burn Care in the Street: A Survey of the Current Landscape of Burn Care Provided by Street Medicine Teams.

People experiencing homelessness are at increased risk for serious burn injuries and face additional barriers to care such as inability to perform wound care and difficulty with follow-up. Although not burn-specific, street medicine (SM) programs provide direct medical care to people experiencing unsheltered homelessness in their own environment and may be well positioned to bridge this gap in burn care for this population. We conducted a cross-sectional survey to characterize the burn care experience of SM teams with providing burn care for people experiencing homelessness.

FireSync EMS: A Novel Mobile Application for Burn Surface Area Calculation.

The percent total body surface area (TBSA) burned is a critical determinant of the required level of care, initial management, and prognosis in patients with burns. The current gold standard for estimating this measurement, the Lund-Browder (LB) chart, requires familiarity with its construction and may not be practical for use by first responders in the field. In this study, we present a novel burn surface area calculator mobile application developed for first responders and validate its accuracy.

Endoscopic Tissue Expander Implantation in Postburn Reconstruction: A Review of the Literature.

Background: Tissue expansion generates new tissue that can be used in postburn reconstruction. Expanders are placed through small incisions, requiring difficult and sometimes blind dissection to prepare an adequate pocket. Recently, the use of endoscopy to assist in expander placement has been described, which may improve intraoperative visualization and allow for a smaller incision.

Burn Patient Insurance Status Influences Hospital Discharge Disposition and Utilization of Postdischarge Outpatient Care.

Postdischarge services, such as outpatient wound care, may affect long-term health outcomes and postrecovery quality-of-life. Access to these services may vary according to insurance status and ability to cover out-of-pocket expenses. Our objective was to compare discharge location between burn patients who were uninsured, publicly insured, and privately insured at the time of their burn unit admissions.

The Impact of No Next of Kin Decision Makers on End-of-Life Care.

For critically ill burn patients without a next of kin, the medical team is tasked with becoming the surrogate decision maker. This poses ethical and legal challenges for burn providers. Despite this frequent problem, there has been no investigation of how the presence of a next of kin affects treatment in burn patients.

Characteristics of Upper Extremity Recovery in Acute Flaccid Myelitis: A Case Series.

Background: Clinical characteristics and timing associated with nonsurgical recovery of upper extremity function in acute flaccid myelitis are unknown.

Methods: A single-institution retrospective case series was analyzed to describe clinical features of acute flaccid myelitis diagnosed between October of 2013 and December of 2016. Patients were consecutively sampled children with a diagnosis of acute flaccid myelitis who were referred to a hand surgeon.

The Homelessness Crisis and Burn Injuries: A Cohort Study.

The United States is facing a growing homelessness crisis. We characterize the demographics and outcomes of homeless patients who sustain burn injury and compare them to a cohort of domiciled patients. A retrospective cohort study was performed at the Los Angeles County + University of Southern California Regional Burn Center for consecutive acute burn admissions in adults from June 1, 2015, to December 31, 2018.

Mesenchymal Stromal Cells Isolated from Irradiated Human Skin Have Diminished Capacity for Proliferation, Differentiation, Colony Formation, and Paracrine Stimulation.

Ionizing radiation, commonly used in the treatment of solid tumors, has unintended but deleterious effects on overlying skin and is associated with chronic nonhealing wounds. Skin-derived mesenchymal stromal cells (SMSCs) are a pluripotent population of cells that are critically involved in skin homeostasis and wound healing. The aim of this study was to isolate and functionally characterize SMSCs from human skin that was previously irradiated as part of neoadjuvant or adjuvant cancer therapy.

Topical Fibronectin Improves Wound Healing of Irradiated Skin.

Wound healing is significantly delayed in irradiated skin. To better understand global changes in protein expression after radiation, we utilized a reverse phase protein array (RPPA) to identify significant changes in paired samples of normal and irradiated human skin. Of the 210 proteins studied, fibronectin was the most significantly and consistently downregulated in radiation-damaged skin.

An update and review of cell-based wound dressings and their integration into clinical practice.

Chronic wounds affect over 4 million individuals and pose a significant burden to the US healthcare system. Diabetes, venous stasis, radiation or paralysis are common risk factors for chronic wounds. Unfortunately, the current standard of care (SOC) has a high relapse rate and these wounds continue to adversely affect patients' quality of life.

Integra-based Reconstruction of Large Scalp Wounds: A Case Report and Systematic Review of the Literature.

Background: Large complex scalp wounds that have traditionally required free vascularized tissue transfer have been successfully reconstructed with skin substitutes such as Integra. Although there are multiple reports of Integra-based reconstructions of scalp wounds, there has not been a comprehensive assessment of this body of literature that critically examines this method. Our goal was to conduct a systematic review to determine the effectiveness of Integra-based reconstructions of scalp wounds, with emphasis on large defects.

The role of congruency in retronasal odor referral to the mouth.

Referral of retronasal odors to the mouth is a fundamental phenomenon of flavor perception. A previous study from this laboratory provided evidence that, contrary to prior speculation, taste rather than touch was the primary factor in retronasal odor referral. The present study further investigated this question by studying the role of congruency between taste and odor on retronasal odor referral under conditions that mimicked natural food consumption.

Potential mechanisms of retronasal odor referral to the mouth.

The current study took a first step toward elucidating the sensory input that drives retronasal odor referral to the mouth. In 2 experiments, subjects performed odor localization tasks under various oral-nasal stimulation conditions that allowed us to assess the effects of direction of airflow, taste, and tactile stimulation on retronasal odor referral. Subjects reported the locations of perceived odors when food odorants were inhaled through the mouth alone or in the presence of water or various tastants in the mouth.